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Organization
SOUL CHOICE COUNSELING, LTD
Active
Organization
SOUL CHOICE COUNSELING, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALYSE A. RYNOR L.C.S.W. (OWNER)
(847) 328-8477
Entity
Organization
Contact information
Practice address
831 FOREST AVE APT 3W, EVANSTON, IL 60202-2421
(773) 332-5471
Mailing address
831 FOREST AVE, #3W, EVANSTON, IL 60202-2486
(847) 328-8477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149006701
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL2251
MEDICARE PTAN FOR CORPORATION
IL
01
—
IL2251001
MEDICARE PTAN FOR INDIVIDUAL
IL
Enumeration date
06/09/2008
Last updated
06/12/2023
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